Human African trypanosomiasis and human immunodeficiency virus co-infection in Western Kenya

Abstract

OBJECTIVE: To determine possible interaction between infections of Trypanosoma brucei rhodesiense sleeping sickness and HIV/AIDS in Western Kenya. DESIGN: Random selection and testing for HIV infections of serum samples from HAT patients using an indirect single phase enzyme linked immunosorbent assay (EAI-Immunocomb II, oragenics). SETTING: National Sleeping Sickness Referral Hospital-Alupe. RESULTS: Four (16%) of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional four (16%) were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P > 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. RESULTS: Sixteen percent of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional 16% were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P < 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. CONCLUSION: T. brucei rhodesiense sleeping sickness is an immuno-suppressive disease whose patients have shown a higher affinity to HIV type 2 infections more common in central and western Africa. Such patients when treated, appear to recover from HAT but later succumb to full-blown AIDS. It is recommended that CD4+ T cell numbers and CD4/CD8 T cell ratios be assessed toinvestigate response to treatment in HIV positive HAT patients.